Dynamic Observation Of Serum Interleukin-6 And Matrix Metalloproteinase-9 In Patients With Cerebral Hemorrhage After Minimally Invasive Hematoma Aspiration

Objective:Hypertensive intracerebral hemorrhage is a clinical common diseases, accounting for 15% of all stroke. In adults over 30 years of age, the incidence rate is 47/10 million for men and 34/10 million for women. Because the morbidity and mortality rates are very high, it is the medical problem to solve urgently. One reason for high mortality is cerebral ede-ma and even cerebral hernia led by rapid formation of intracranial hemat-oma directly oppressed the surrounding brain tissue. Therefore removing the hematoma and normal brain tissue pressure to reduce intracranial pressure to become one o effective way to save cerebral hemorrhage. Minimally invasive removal of intracranial hematoma technology (referred to as minimally invasive surgery)can remove hematoma of oppression rapidly and effectively so that to reduce intracranial pressure. The most minor injuries and the fastest speed to remove the hematoma, which also reflects the modern neurosurgery concept to treat hypertensive cerebral hemorrhage. Through the minimally invasive treatment to cerebral hemorrhage and interleukin-6 and matrix metalloproteinase-9 levels were measured in patients with acute cerebral hemorrhage in order to explore clinical significance during the development process of cerebral hemorrhage, and to study the infection on the pathophysiology of cerebral hemorrhage by minimally invasive surgery.Methods:Cerebral hemorrhage patients were divided into minimally invasive group and control group, both two groups of patients meet the diagnostic criteria and exclusion criteria. Two groups of patients were conventionally given dehydration reduce intracranial pressure, blood pressure control, blood sugar control, antibiotics, nutrition support therapy. Within 24h after onset and agreed by the family, Minimally Invasive Group were given the hematoma Minimally invasive surgery with a diameter of 3mm of the YL-I type one-time intracranial hematoma puncture needle under local anesthesia in strict accordance with "minimally invasive removal of intracranial hematoma technology standardized treatment guidelines". The two groups at admission and 2,7,14 d after the onset of the morning fasting venous blood collected elbow 4mL, centrifugal extraction of serum placed in the upper-80℃refrigerator prepared test. Using enzyme-linked immunosorbent assay (ELISA) detection of IL-6 and MMP-9 levels, operating strictly according to kit instructions. Determine the efficacy of the standard by 1995, the 5th National Conference adopted by cerebrovascular disease, "patients with stroke neurological impairment score standard" for efficacy evaluation. The neurological deficit score was given to two groups of patients on admission and 14 days of treatment, according to changes in neurological deficit scores and the degree of invalidity classification to determine the curative effect.Using SPSS 11.5 software for data processing. Test significance level of P<0.05.Result:1,Changes of Serum IL-6 and MMP-9 content In two groups of patients with cerebral hemorrhage hemorrhage, MMP-9 and IL-6 were detected within 6h and up to the peak in 2days, then minimally invasive group of MMP-9 and IL-6 rapidly reduced at a low level in 14 days. While the control group decreased more slowly and maintained the high level throughout the acute phase. The serum MMP-9,IL-6 levels of the two groups were no statistical significanc on admission (P> 0.05); The peak value of minimally invasive group compared with the control group was significantly lower (P<0.05); In 7,14 days after surgery, minimally invasive group were significantly lower than control group (P＜0.05).2,Changes of NDS score The two groups on admission in patients with NDS was no statistical significance (P> 0.05); 14 days after surgery minimally invasive group NDS score was significantly lower than the control group (P<0.05).3,Serum IL-6, MMP-9 level and condition of the disease The correlation analysis showed that two groups of patients with cerebral hemorrhage serum IL-6, MMP-9 levels are related to the day of NDS score on admission and 14 days aftertreatment into a positive correlation.4,Clinical efficacy Minimally invasive group was significantly superior to the control group in the total effective, the difference was statistically significant (P<0.01).Conclusion:Serum IL-6 and MMP-9 levels significantly lower in surgery group than the control group,so they can be used as biological indicators to evaluate the effection of minimally invasive treatment of cerebral hemorrhage.